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UNITED STATES OF AMERICA. 



ERE 10 SEP PAT 



MINERAL AND OTHER WATER CORES 



CLIMATIC TREATMENT. 



DR. THOMAS LINN, 

Doctor of Medicine \ Faculty of Paris ; Doctor of Medicine and Surgery , 
University of New York; Me?nber of the British Medical Associ- 
ation; Member of the Continental Anglo- American Medi- 
cal Society ; Membre de la Societe de Medecine Pra- 
tique de Paris ; Me??ibre de la Societe" de Mddecine et 
Climatologie de Nice ; Physician to the Bath- 
ing Establishments at Aix-les-Bains and 
Marlioz (in Summer) ; in Winter 
at No, 16, Quai Massena, 
Nice, France. 




1894. 
GEORGE S. DAVIS, 

DETROIT, MICH. 



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Copyrighted by 
GEORGE S. DAVIS. 

1894. 



TABLE OF CONTENTS. 



CHAPTER I. 

PAGE 

Introduction 1-3 

CHAPTER II. 
Mineral Waters — Hydropathic Stations — Sand and 
Mud Baths — Milk, Whey, and Grape Cures — 
Massage and Electricity 4-13 

CHAPTER III. 

Climatic Resorts : Winter, Summer, Sea-Sides, and 
Mountains — Air Cures — " Terrain-Kur " or Ex- 
ercise Treatment 14-26 

CHAPTER IV. 
Alphabetical Index of Maladies, with Names of the 
Best Places to Send Patients to in Europe. ..27-76 



INTRODUCTION. 



The question may be asked, why we should send 
patients away to health resorts in Europe when we 
have at home springs and climates that are as useful 
for their treatment. 

We can admit at once that the home establish- 
ments are well appointed and have competent physi- 
cians, while everything that nature and medical art 
can give is to be obtained there. Then, again, why 
send patients elsewhere ? 

First of all, it may be out of our power to do 
otherwise, the family having already decided upon a 
tour in Europe for pleasure, instruction, or for business 
reasons of one of its members; and the treatment of 
the patient while absent is the only question we are 
called upon to decide. 

Next, a complete change may be most necessary— 
a new land away from all the old associations or the 
chance of returning to them quickly by train, strange 
faces, change of habits and customs, different food 
and language, the soil even of another character, so 
that the body as well as the mind benefits by the 
novel surroundings. 

Then we-must say that the large experience that 
has been gained in European resorts, where for so 
many years the records of treatment of certain dis- 



eases have been kept, has a resulting effect upon 
therapeutics that is quite apart from the chemical 
composition of any mineral-water or the temperature 
of a climate. 

These years of accumulated evidence, and the 
thousands of scientific medical experiments, added to 
the really magnificent curative establishments, have 
brought treatment in them to a point of perfection 
which accounts for the preference given to health 
resorts abroad. 

The European watering-places are very numer- 
ous, and it is quite impossible for many of our medi- 
cal brethren to have a correct idea of the treatment 
given at all of them. It is known in a general way 
that Vichy is good for stomach complaints, that 
Carlsbad is a purgative water useful in liver troubles, 
and that Nice in the south of France has a good, tonic, 
mild climate in winter; but there are not many of the 
home physicians who have had the time and oppor- 
tunity of frequenting the health resorts of Europe and 
making a study of their methods of cure, so that they 
are not always in a position to indicate the different 
stations for each disease to make a cure at. 

The author will endeavor to supply this informa- 
tion in a concise form for ready reference by physi- 
cians. He wishes to mention that he has made it a 
special point, during a number of years' practice 
abroad, to visit the health stations and study their 
methods of treatment, besides having sent patients to 



— 3 — 
them and observed the results. He also practices 
himself at a well known European mineral-water 
station in summer, and at a popular climatic resort in 
winter, and has had access to the fullest scientific 
details concerning balneo-therapy and climato-therapy 
in Europe, so that he trusts the indications given will 
be accepted as being the nearest possible to the cor- 
rect ones, given without partiality, and the best places 
to send patients to for treatment when abroad. 

I give only the names of the places recom- 
mended for the different maladies, and must refer the 
reader to guide-books for routes to the stations and 
the fullest details of each place; most of them publish 
monographs of the stations in different languages. 



MINERAL WATERS— HYDROPATHIC ESTABLISH- 
MENTS—SAND AND MUD BATHS— MILK, 
WHEY AND GRAPE CURES— MAS- 
SAGE AND ELECTRICITY. 

Hydro-mineral medication has changed consid- 
erably in late years. Formerly it was thought that the 
small quantity of the salts of lithium, arsenic, iodine, 
or bromides with sulphur found in the waters, had an 
immense influence over disease; but now that it is 
known that the mineral elements are often infinitesi- 
mal in quantity, and that very few of the mineral 
waters have an extraordinary action per se on the 
organism, this influence is no longer considered the 
preponderating one in the cures made, and the former 
absolute faith in the mineral constitution of the 
waters is now much weakened, for it is clear that the 
other elements of the cures are very important. 

What really acts at many of the springs is the 
water itself, hydro-therapy, life in the open air, 
hygiene, change of scene and habits, exercise, rest 
from business, as well as the mineral elements them- 
selves, for I do not mean that no advantage is to be 
gained from the mineral salts found in the waters — 
far from it; but they are not the only agencies to look 
to for curative action at the resorts. 

It is often the method of application of the 
waters rather than the kind of water. Priessnitz, the 



great founder of water cure, used nothing but the 
common water of a mountain stream, and made won- 
derful cures. It is the same with the more modern 
Father Kneipp. 

I cannot in this little volume say as much as 
I would like to about the mineral waters, but must 
refer to the larger works on the subject. I may 
mention, however, that they are usually divided into 
five classes: Sulphurous, Saline, Purgative, Alkaline, 
and Ferruginous. 

The Sulphur springs act best in chronic lym- 
phatic patients. The Salt ones are much used for 
strumous troubles. The Purgative waters have a wide 
scope, and the Alkaline springs are of great import- 
ance in internal medication. The Iron-water springs are 
not so much used as they deserve to be, for excellent 
results are obtained at them. A number of the Sul- 
phur-waters contain iodides and bromides. The Alka- 
line ones often contain arsenic, some of them have it 
in considerable quantities. Copper, mineral tar, and 
many other important elements are found in some of 
the waters; others again act almost alone by the natu- 
ral temperature of the water. 



ADVICE DURING A MINERAL-WATER CURE. 

The moment a patient arrives at the springs he 
should place himself under the absolute direction of 
the doctor there to whom he has been sent. 

To undertake to swallow more water than is or- 
dered, through the false impression that because it 
is good for one he cannot take too much of it, is to 
expose oneself to a grave error that under certain 
circumstances may become a serious danger. The 
old Romans were great bathers and also drinkers of 
mineral water. Pliny says: " A considerable number 
of patients boast of resting hours in the baths, which 
is bad for them, and I have seen them drink so much 
of the spring water that their skin was so stretched 
that it covered over their rings." 

We don't feel sure that Pliny was not doing here 
as some other historians do, that is, stretching his facts; 
but in any case, no more mineral water should be 
drunk than is ordered by a doctor of the place who 
knows by experience the useful quantity. 



BEST SEASON FOR THE COURSE, AND ITS 
DURATION. 

The bathing establishments are, many of them, 
open all the year round, but the doctors do not advise 
patients to go to them before May nor to remain after 
October. English visitors rather prefer cold weather, 
and they often arrive for the baths in May, and return 
again in September. Americans come during the 
whole season, but prefer the summer. The most 
fashionable and crowded time is during July and 
August. This is true of all the mineral springs of 
Europe, and the question may be asked if the world 
in general is right in flocking in thousands to the 
baths during the hot months ? Certainly severe 
rheumatic cases, old people, and those sensitive to 
cold, must find it best for them to come at this time, 
or they would not do so in such great numbers. The 
months of May, June and September have certain 
advantages; the baths are not so crowded, the air is 
more bracing, and reasonable rates prevail. 

As to the duration of the treatment: it has been 
rather arbitrarily fixed by custom at three weeks, or 
twenty-one days, and many take about sixteen douches 
or baths in this time, with one or two days' rest 
between, but this should all depend upon the case. 
Almost every patient demands a careful study by a 
competent bath physician, who alone can fix the 
proper duration and number of douches. 



— 8 — 

It may be said, though, in a general way, that 
many people get sufficient treatment in three weeks. 
Some cases require two seasons to cure a chronic 
malady, but all get improvement in a single one. It 
is important that the baths and douches be not taken 
continuously; brief intervals of rest are essential to 
success in the treatment. .This is the experience of 
the best physicians who have practiced for many 
years abroad. An " after cure" of some little time in 
a cool mountain-resort is always advisable. 

The therapeutical action of hot mineral-waters 
and douches, with massage, we may explain as follows: 

There is produced an energetic stimulation of 
the cutaneous surface, which results as it were in a 
purgation of the skin, making it eliminate whatever 
excrementitious matters may have been retained in 
the organism. It also relieves at the same time any 
congestion of the deeper parts or organs, while giving 
a stimulus to the circulation in general. To this must 
be added the effects of the mineral elements in the 
waters taken into the system and blood, both by 
drinking them and by inhalation during the bath or 
douche. 

We must add a word of warning to patients who 
are disposed to take powerful massage douches with- 
out advice, as harm can result from an injudicious 
use of them. Some people insist on the masseicrs 
giving them a vigorous treatment when they have no 
proper power of reaction, so that they simply exhaust 



— 9 — 
themselves and produce a state of feverish debility 
and weakness, whilst under proper medical direction 
the same persons could derive great benefit from 
mineral waters scientifically used. 

Just here I would like to mention a specialty 
at Aix-les-Bains; this is the carrying home of the 
patient after baths or douches. The custom is to 
walk to the bath house (although one may be 




Bath Chairs. 

carried to it if desired) ; the hotel servant carries a 
blanket' and linen to the establishment, which is 
furnished without extra charge by the hotels. The 
bather, having disrobed in the dressing-room at- 
tached to the douche, enters the bath, and his usual 
clothing is returned to the hotel by the servant. 
After the douche and rubbing down, the patient is 
carefully wrapped in the blanket, which has been 
warmed in a gas oven in the meantime, and, the bath 
chair having been brought into the dressing-room, 



10 

the patient is put into it and carried to the hotel, up 
to his room, where he is deposited in bed and left to 
perspire a certain time, when he is again rubbed down 
by the attendant, or by himself, and resumes his usual 
attire in time for breakfast. 

This I consider an important part of the Aix 
treatment. How much harm is done and how many 
colds are caught elsewhere by the usual method of 
taking baths and then dressing quickly in hot dress- 
ing-rooms, and walking home with the pores of the 
skin open, while the weather may be cold or wet! 

It is all very well to advise that patients dress 
quickly and go for a walk, or hurry home and go to 
bed or stay in warm rooms covered. But nothing 
seems to protect rheumatic and sensitive people from 
catching cold after baths as does the above system 
used at Aix. 



THE DOUCHE-MASSAGE IN RHEUMATISM. 

One of the most important applications of the 
Aix waters is the massage or shampooing of the pa- 
tient while under the hot sulphur-water. This is done 
here with a perfection not to be found elsewhere in 
the world. The men and women who perform it 
have had their art handed down to them for many 
years, as their fathers and mothers have been "mas- 
seurs" or "masseuses" before them. The Aix waters 
have an unctuous quality that makes them particularly 
adapted to rubbing and kneading the muscular struc- 
tures—a property not found in other waters. 

The Douche-Massage is given as follows: 




The Douche-Massage. 



t\ D 



12 

The patient is placed on a wooden stool, and the 
attendants pour the water over the body from a hose, 
while at the same time they shampoo, knead, and rub 
according to the directions given by the physician, 
who accompanies the patient to the douche the first 
time, to give instructions as to temperature, force, 
duration, and pressure on particular parts. 

This specialty of massage under water has noth- 
ing in common with the dry massage or that practiced 
with ointments elsewhere. 

Hydropathic Stations. — Besides the mineral-waters 
proper, there are a number of excellent water-cures, 
where the scientific application of pure water is prac- 
ticed under medical direction, and with sufficient 
pressure to accomplish good results in the treatment 
of a large number of diseases. The large cities have 
also good establishments of this kind; some of these 
will be mentioned under the diseases for which they 
are appropriate. (See Hydropathic Establishments^) 

Sand and Mud Baths. — Putting the patient into a 
pit dug on the sea-shore and covering portions of the 
body with sand, is a form of treatment which is still 
in use in certain parts of Europe, such as Arcachon 
and other sea-beaches. 

The Mud Bath is a variety of this. The mud of 
rivers and some springs is put into a bath-tub and 
heated with steam. The patient gets into this, or 
else it is applied locally to joints like a plaster, while 
hot. This is done at Dax, St. Amand, and Marien- 



— 13 — 
bad. Mud is now sent to Paris from Dax and ap- 
plied there in the same manner as at the Springs, at 
private bathing establishments. 

Milk, Whey, and Grape Cures. — These methods 
of cure are used now at nearly all the stations: Mont- 
reux, Meran, and Pugny are grape cures. 

Massage and Electricity . — These are given at most 
of the stations, the last at all the hydropathic estab- 
lishments. Massage under water is the specialty at 
Aix-les-Bains. Dry massage or massage with various 
pomades, lanolin, etc., is now practiced almost every- 
where in Europe. 

The health resorts and large cities all have these 
shampooers, or masseurs and masseuses, men and 
women who are practiced in this art of rubbing. Their 
addresses can be had from the physicians in each 
place. 



CLIMATIC RESORTS: WINTER, SUMMER, SEA- 
SIDE, AND MOUNTAIN— AIR CURES— 
"TERRAIN KUR" OR THE EXER- 
CISE TREATMENT. 

Winter Stations. — The Mediterranean coast-line 
is thickly set with renowned health resorts that are 
certainly the best wintering places in Europe for many 
reasons. 

We have for years sought "what does not exist" 
that is, a perfect climate — one where it would be 
neither too cold nor too hot, without rain, wind, snow, 
or frost. 

Two years in Egypt proved to me that it could 
rain and hail even there, and that the cold was felt 
all the more as the houses are devoid of fire-places. 
Besides this discomfort, one has to read there his 
London paper six days old as the latest news, which 
makes him feel that the real world is afar off. . In 
many other winter resorts I had the same difficulty 
of finding perfect weather with comfort, and I must 
confess that even in the favored region of the south 
of France (where the change from northern lands is 
so wonderful, and where flowers are blooming and 
birds singing in midwinter), even there the snow can 
now and then be seen on the tops of the far-distant 
Alps, which prevent its falling into this sunny strip 
of land, and disagreeable winds will sometimes arise, 
while the exhilarating sunshine may prove treacher- 



— i5 — 
ous if proper precautions are not taken; but after all 
these little troubles, there is no place in the world where 
so many climatic and other advantages can be had as in 
the French Riviera. One of the greatest points is 
that it is only eighteen hours from Paris, and twenty- 
five from London and the great centres of Europe. 
There are few of us in these modern days of civiliza- 
tion that can bear to go to outlandish places, away 
from reach of the best advice and scientific aid, par- 
ticularly when we are ill and far from home and 
friends. We feel then that we ought to have every 
possible accommodation at hand, even with our de- 
sire for a fine climate in winter. This can be had in 
Nice, and on the Riviera, where every comfort is ob- 
tainable: the telegraphic news is laid on the break- 
fast table every morning in the Paris and London 
papers, while in the larger towns everything that 
modern taste demands is provided. 

As to climate, it is admitted that u the country 
which allows us to spend the most time in the open air is 
the best one for invalids in winter." This is the rule 
for perfection in winter resorts, and it is as nearly ap- 
proached as possible in Nice and the south of France, 
where it Is rare that a day comes when one cannot go 
out during at least some portion of it. It must first of 
all be observed that there is no such thing as a tropi- 
cal climate in continental Europe, or even a very warm 
one, in winter. The best that can be found is a fairly 
mild one with a sunny atmosphere, slight rainfall, no 



— i6 — 

fogs or snow, and a tonic dry air. In Nice, between 
October and May, there are over two hundred clear 
sunny days, while in the same time in London there 
are not more than a dozen. 

The main characteristics of the Rivieran climate 
are much the same in all the resorts on the Mediter- 
ranean, but each has its secondary qualities— certain 
spots or portions of each town are more protected 
than others. For instance, at Nice, which is on a 
broad mountain torrent called the "Paillon" where it 
comes down from the northern range of mountains, 
it leaves a way open to the north winds, and some of 
the hotels and public places are within this tract; but 
this does not prevent Nice from having certain quar- 
ters as well protected as any along the coast. There 
are places in its Vallon des Fleurs, Brancolar and 
Carabacel quarters which have full protection and are 
sheltered from all winds, while they have several de- 
grees of temperature more than the other districts. 
Among the resorts in the south, some accidental pro- 
tection by a hill or a clump of trees makes all the dif- 
ference — the rest is the same at all the stations. This 
accounts for the important advice to patients not to 
locate themselves in any of the towns in the south of 
France without consulting a local physician first. 

Everything also depends on the sun here, so invalids 
must be warned not to accept any rooms but those 
that look south, or what is called " au midi" so that 
they will have the full benefit of the sun's rays. 



DO NOT TRAVEL SOUTH TOO QUICKLY. 

One of the disadvantages of the splendid new 
express trains deluxe is that they make people take too 
sudden a change of climate. All strangers need to be 
acclimatized here as elsewhere, according to their 
personal peculiarities and constitution. Some suffer 
by these sudden changes in loss of sleep and appetite; 
others get too great an impulse in their digestion 
from the tonic air giving them an unaccustomed zest 
for food, and they over-eat. Again, others get a con- 
siderable increase in their catarrhal troubles for a 
time, or some disorder of the nervous system. So 
that a slower trip south is advisable for invalids. 
This precaution is not so important perhaps as the 
others, as care in eating and a few days' quiet rest in 
the hotel will obviate the inconveniences of a rapid 
change when the latter cannot be avoided. 

Hippocrates advised physicians who had settled to 
practice in a place, first of all to consider its medical 
topography, seasons, winds, water, climate, etc.; and 
as a large number of competent men have already 
studied these subjects for more than half a century 
past in regard to Nice and the Riviera, I have only 
to add my personal experience, to give my readers 
the actual facts in the case, which are not based on 
speculation or theory, but on sound investigation and 
honest research, which should be the foundation of 
all science. 

2 TTT 



THE REGIMEN MUST BE CHANGED IN THE 
SOUTH. 

The food and drink of the North are not suitable 
here. Nothing, perhaps, does more harm than the con- 
servatism of the English and Americans, and for that 
matter those of other nations, who will insist on taking 
their home habits with them wherever they go. Eng- 
lish ale and the heavy meat foods of the North are 
not suitable in the South. It is a safe rule to confor?7i 
i?i most things to the habits of the people in the place you 
live in. There is no use fighting against a change of 
climate; it is just as hopeless as planting flowers in a 
soil that does not suit them. The matter of regimen 
alters, however, with each separate case, and cannot 
be fully dealt with here; the suggestion is thrown 
out that if you want to feel well, then suit your habits 
to the climate. 

It dates back to the highest antiquity that after 
long and patient observation physicians recommended 
delicate patients to pass their winters on the Mediter- 
ranean, and modern science can only confirm the 
efficacy of this good advice. It may be that the 
microbian theory of the cause t of pneumonia and 
kindred complaints is correct, but certainly the part 
taken by exposure to extreme cold and damp is the 
most important factor in all these troubles. This we 
know to a certainty by clinical facts, and this knowl- 
edge is of more value than a thousand theories. 



— i 9 — 

Even if the microbes be the seed of disease, they 
will not develop on healthy soil, so to speak; and 
the ground must be prepared to receive them. The 
mechanism of this preparation is only too well known: 
we get overheated in a damp, cold climate, and we 
"catch" the disease. The mere mechanical effect of 
cold, contracting the little blood-vessels which run 
just beneath the surface of the skin, drives away the 
blood from these parts and must create a congestion 
-somewhere else — most likely in one of the vital 
organs, or wherever we have our weak spot, the so- 
called "locus minor is resistentice" (and few of us can 
boast of being free from an imperfection of some 
kind); this part is of course least apt to recover 
promptly from the temporary congestion produced, 
and disease follows. The old saying, " Warmth is life, 
cold is death" is true. How cold checks perspiration, 
thus preventing the carrying off of injurious worn-out 
materials from the body, is well known. Thus the 
work of purification is thrown on the internal organs, 
— lungs, kidneys, etc.; and they have to try to perform 
the work the skin can no longer accomplish. When 
they are not in good order, congestion again results. 

It is wonderful how quietly we all take dangers 
that come upon us in a familiar form. If an epidemic 
arises, and kills off a thousand people in a few weeks, 
the world is alarmed and almost a panic is produced; 
but severe cold last winter in London destroyed one 
thousand in four weeks, and yet nothing was said. 



20 

The death-rate before the frosty weather was 20.4, 
but it rose then to 29.7. The year before, during the 
influenza, it fluctuated about 21. Little heed is taken 
of this warning and lesson, or of the fact that it is 
perfectly true that the great majority of people who 
live in cold, damp climates "perish by the lungs." The 
direct influence of cold itself per se cannot be denied. 
It may be that it places individuals in a state of bacil- 
lary receptivity, but the part taken by it is the most 
important one, and it must be admitted that all per- 
sons subject to diseases of the respiratory tract give 
themselves the best chance of escaping dangerous 
illness by wintering in the South. Drugs in such 
cases are often but palliative. The failure of all the 
modern cures proves that the best one for all chronic 
bronchial troubles with profuse secretions is a pro- 
longed residence in a mild, dry climate. Sufferers 
from dry bronchitis do better in damp places like 
Algiers and Pau. It must be remembered that only 
the patients who suffer from the passive variety of 
phthisis do well in the South. The good effects of 
such an atmosphere as that of Nice on chronic inflam- 
mations of the larynx, nares, etc., are certain and 
sure. 

But the advantages of wintering South are not 
confined to chest complaints. Next in importance 
to derive benefit from a residence on the Riviera, 
are all feeble subjects, whether from age or faulty 
constitution. The large class of weak subjects do 



21 

well here because their temperature is kept up and a 
reaction is created by the dry, stimulating, tonic air. 
This also acts on the digestive organs, and dyspeptics 
get an appetite and are able to assimilate food much 
better here than in the North. 

The action of the light and dry air on hypo- 
chondriacal, melancholic, and anaemic patients is well 
known. 

Diabetes, skin diseases, as well as calculous 
affections, are also relieved, because, the functions 
of the skin being better performed in the South in 
winter, the work of the other organs is eased. 

Women's complaints are very much relieved here 
(dysmenorrhoea, etc.). 

Paralysis, rheumatism, sciatica, and gout are 
ameliorated constantly. 

In one word, all chronic maladies are benefited by 
the climate of Nice and the Riviera. 

The only exceptions known are certain nervous 
complaints. 

(Under the heading "Alphabetical Index of the 
Various Diseases" will also be found the proper indi- 
cations for them, not only as to climatic places, but 
also the mineral and other water cures.) 

The winter resorts in Europe may be divided 
into three classes: 

First Class. — The mild, dry, sunny, tonic climatic 
places in the French Riviera: Hyeres, St. Raphael, 
Cannes, Nice, Monaco, Monte Carlo, with Mentone 



22 

and their suburbs. Next the Italian resorts: Berdi- 
ghera, Ospedaletti, San Remo, Alassio, with Corsica 
and Algiers. 

Second Class. — The fairly good winter climates of 
the Eastern Riviera, below Genoa, which are damper 
and colder, but still sunny: Nervi, Spezzia, Naples. 
While next to them may be ranked Montreux, Meran, 
Arco, and Gardone-Riviera. 

Third Class. — The very cold, sunny, high-moun- 
tain winter resorts, such as Davos-Platz, Pontresina, 
and St. Moritz. In these high valleys the sun shines so 
strongly that in mid-winter it is often possible to go 
skating in light clothing; while the thermometer in 
the shade is below freezing-point the»sun heat may be 
considerable. 

I shall not enter into the great discussion as to 
whether mild, sunny, sea-side winter resorts are better 
than the very cold, high, mountainous ones. I think 
that the personal equation is the best rule to go by. 
If a patient likes cold and has a good reaction, the 
mountains may be best for him; but if he prefers the 
mild climates of the South, they should be allowed. 
The essential is plenty of sunshine, and outdoor life 
and air, combined with the other elements of cure. 

Summer Stations. — Nearly all the mineral-water 
springs are summer watering-places, being situated in the 
mountains, and they are often climatic air cures, so 
that not much need be said here except to mention 
that almost all of Switzerland is an excellent summer 



— 23 — 

watering-place for mountain air. The elevation of 
the country is from 700 to 15,000 feet, and in general 
it is a cool and often wet country, even in summer 
time. In some of the more narrow valleys, it is true, 
the heat is at times oppressive, but in most of the higher 
regions it is cold up to July and August, and in some 
years even during these months. 

Switzerland is mostly a country to visit for 
pleasure, however, outside of its excellent mineral- 
water stations and milk cures. 

Some of the special air cures of Europe are Gor- 
bersdorf and Falkenstein, in Germany; Vernet, and 
Pugny-les-Corbieres at Aix-les-Bains, in France. (See 
Phthisis, in Alphabetical Index of Maladies, etc.) 

Sea- Sides. — The resorts on the Atlantic coast are 
very numerous, comprising all the well known sea- 
side places on the English Channel, together with the 
French and Belgian ones. The Mediterranean sta- 
tions differ from the Atlantic by having no breakers 
and being in a mild climate, so that baths can be 
taken even in winter. The whole Mediterranean 
coast has a large number of these resorts, from the 
Italian frontier at Ventimiglia to San Remo, Bordi- 
ghera, Alassio, Nervi, Spezzia, Leghorn, and on down 
to Naples, where we find the islands of Ischia and 
Capri. The Adriatic side is not frequented by stran- 
gers. Cannes, Nice, and Mentone, while they possess 
bathing apparatus, are used mostly by the natives in 
summer time, although there is no question that 



— 2 4 — 

the famous inland sea has more salt in it than the 
Atlantic, so that the baths should be of great value. 
But fashion has decreed otherwise, and the world 
blindly follows it and goes to the Atlantic sea-side 
resorts. The temperature is never excessive on the 
great tideless sea, even in summer. Still it must be 
admitted that it is colder at the sea-side in the North, 
and there are no breakers in the southern sea, as I 
have already said. The French sea-coast is a very 
long one, stretching as it does all the way from Dun- 
kerque and Calais on the English Channel to the 
Atlantic by Arcachon and Biarritz, on again to the 
Mediterranean, and along its coast from Marseilles to 
Mentone. The most frequented places are Dieppe, 
Boulogne-sur-Mer, Etretat, Trouville, St. Malo, Houl- 
gate, Dinard, Dinan, Concarneau, Royan, Arcachon, 
Biarritz, and St. Jean de Luz — these all on the Atlan- 
tic side; Biarritz on the Bay of Biscay has no less 
than three large amphitheatre-shaped beaches, with 
splendid breakers constantly rolling in from the 
ocean, so that it can be recommended as affording 
the finest and most bracing sea-bathing in France. 

Under this heading I should, perhaps, have 
mentioned the sea-side resorts in Great Britain first, 
as it is usually the country American travelers first 
reach. The beaches here are very good, as a rule, 
with smooth sands and excellent breakers. If a 
bracing place is wanted, the east and southeast coast 
should be chosen; if a milder locality, then the west. 



— 2 5 — 
Queenstown, Aberistwith, Scarborough, Covves, Folk- 
stone, Dover, Brighton, Ramsgate, and Margate are 
the best known resorts. 

Therapeutics of Sea-Baths. — Sea-baths are indi- 
cated in muscular debility and exhaustion, tuberculo- 
sis in joints, white swellings, etc. They help those 
who need repose, and convalescents. 

Sea-bathing is adapted for delicate women and 
girls, and also for children and over-worked men. It 
improves the general health and braces the system 
against catching cold, and is a tonic to the cerebro- 
spinal system. We must make special mention of its 
effects on scrofulous children. The contra-indications 
are eye diseases, and some of the skin diseases, as 
well as chorea and convulsive troubles of any kind. 
Sufferers from diseases of the heart and lungs, gout, 
with any tendency to cerebral congestion, as well as 
highly irritable and nervous people, had better not 
use sea-baths. Mountain air would be best for such 
cases. 

We might here make a few suggestions for pa- 
tients going to sea-side places: first, to bathe at the 
warmest time of the day — say n to 12; next, never 
soon after a full meal or when very tired. 

It is well to go in while warm from exercise, and 
not follow the old plan of getting cool before entering 
the water. 

One should not stand about half-dressed after- 
wards, but walk or return to warm rooms. 



— 26 — 

The "Terrain Kur" is Professor Oertel's method 
of treating weak muscular hearts by ascending walks. 
It is useful also in obesity, neurasthenia, and in cases 
of defective pulmonary expansion. Meran, Arco and 
many of the German places are known for this treat- 
ment, while Pugny-les-Corbieres at Aix-les-Bains has 
now introduced it in France. 

These walks seriously carried out on this system 
are now quite popular, and many of the European 
stations have regulated gentle ascents marked out 
with the height at each few hundred yards, and 
benches to repose upon. 



ALPHABETICAL INDEX OF MALADIES, WITH 

NAMES OF RESORTS IN EUROPE 

TO SEND THEM TO. 

I give the leading indications of the important 
places (many more could be added), mentioning them 
in the order of merit or success in the treatment of the 
diseases, given as nearly as possible. 

It is understood, of course, that all the health 
stations are good for certain complaints; for instance, 
anaemia and debility may be improved at any of them, 
while rheumatic complaints are treated with more or 
less success at all hot springs. 

The exact indications for each mineral spring are 
much controverted, every writer finding different 
ones, but I mention the station best suited to each 
malady according to the experience of the largest 
number of authorities. 

Space does not permit of my giving more than the 
name of each resort, and the larger works on the 
places must be consulted for particulars in regard to 
any special one selected. The usual European Guides 
will give the routes and practical directions. 

Concerning many of the larger European sta- 
tions, large volumes have been written in different 
languages; application may be made for these to 
local physicians or to the director of the bathing 
establishment or springs. 



— 28 — 

Addison's disease may possibly be improved at the 
stronger arsenical waters, such as La Bourboule, 
Levico, etc. Hot douches upon the lumbar region for 
the pain in this disease are considered useful, and can 
be had at all the water-cure stations. Milk-diet treat- 
ment, so well given with "sterilized milk" in Switzer- 
land, is also a useful aid in supporting these patients. 
Certainly, assiduous or even forced feeding of a com- 
plete aliment seems to check the progress of the dis- 
ease for a time at least. 

Ague, — La Bourboule, arsenical waters. Royat, 
Vichy, in France. Bath, in England. Carlsbad, in 
Austria. Marienbad, Tarasp, Homburg, Ems. 

It is probable that the action of the arsenical 
mineral-waters is most useful in malarial anaemia, 
and they are certainly of great service as a prophy- 
lactic to persons who have to live in malarial districts. 

Anglo-Indians and Colonists resort largely to 
these waters, finding themselves protected from fever, 
by their use during one season, for several years 
afterwards. 

A sea- voyage and a stay at a northern sea-side, 
after residence in malarial countries, is also useful; 
while mountain air after residence in lowlands is cer- 
tainly so. In fact, in all such cases the well known 
rule is to make a complete change from the place the 
disease was contracted in. This is perhaps the most 
important rule in malarial treatment. Hydropathy is 
important; see Cold-Water Cures, 



— 2 9 — 

Albuminuria [chronic Bright* s disease). — For the 
diuretic effect, any of the alkaline waters, such as 
Vichy, Vals, Royat, Bilin, Evian, Plombieres, Buxton, 
Contrexeville, Vittel, Ems, Harrogate, Homburg, salt 
waters, Neuenahr, Wildungen, Kissingen. Nearly all 
the mineral waters contain iron, but if there is much 
anaemia some of the stronger ferruginous ones may 
be tried, such as Spa and Schwalbach. In winter the 
bright climate of the south of France — in particular 
Nice, owing to its being a gay, lively place — is useful 
for these depressed patients. Madeira, Canaries, Nas- 
sau; also milk cures. 

All the milder carbonated waters may be used 
and drunk in considerable quantities; Carlsbad in 
small quantities and with caution. 

Protracted warm baths at the same time as the 
use of the water internally. 

When the cases are far advanced, those waters 
that contain iron are best. 

In the cirrhotic form of Bright's disease, constant 
purgation with the saline waters, Hunyadi Janos, 
Friedrichshalle, etc., may be tried at home or at the 
springs. When ursemic symptoms appear, the hot wet- 
pack has done good. 

Alcoholism (see Intemperance also). — Vichy, Carls- 
bad, and the alkaline springs in general are useful to 
help the stomach. 

The mild restraint of the inebriate, or hydropathic 



— 3° — 
asylums, can be strongly advised for as long a period 
as possible. 

The milk and grape cures at Meran, Montreux, 
and other stations can also be recommended. 

Pougres and Royat both help the chronic gastritis 
in these cases, while Chattel Guyon is a station in 
France whose laxative alkaline waters are quite cele- 
brated for this condition when there is sluggishness of 
the bowels. 

Carlsbad, in Austria, when there is some liver dif- 
ficulty and when the abdominal viscera need rousing. 

Alopecia. — All the hot sulphur baths for baldness: 
Aix-les-Bains, Luchon, Harrogate, etc. 

Amaurosis. — Several springs claim to help vision, 
such as Brides in France, Carlsbad, Marienbad, Kis- 
singen; and Voslau, near Vienna, in Austria, also, for 
the grape cure. 

Amenorrhoza. — St. Sauveur, Neris, and Aix-les- 
Bains, in France; Schwalbach, Franzensbad, Hom- 
faurg, Kreuznach, and Pyrmont, in Germany; Bath 
and Bushey, in England; while all the warm winter 
resorts — Nice, Cannes, Mentone — are celebrated for 
the facility with which women's functions are per- 
formed in winter time. 

Massage of the abdominal walls alone, or even 
uterine massage in conjunction with mineral and other 
~water cures, is clearly indicated in these cases. 



— 3i — 

Electricity is also useful and can be had at most 
of the foreign resorts. 

The warmer waters are best when there is neu- 
ralgic suffering, when local applications are used with 
great benefit. 

Ancemia. — Here, as mentioned elsewhere, the 
list is a long one, so many places helping the condi- 
tion, but I give only a few of them. First, the iron 
waters at Spa, Bath, Tunbridge-Wells, Pyrmont, 
Schwalbach, Homburg, Franzensbad, The Hydro- 
pathic Establishments, Forges, Bussang, Royat, La 
Bourboule, Chatel Guyon, St. Moritz, Levico, Marien- 
l)ad. Then the sea-side places, St. Malo, Biarritz, 
Arcachon, Trouville, Ostend. The climatic stations 
all over Switzerland. Meran, Glion, Pugny-les-Cor- 
bieres at Aix-les-Bains. Winter climates of a tonic, 
sunny nature, Nice, Cannes, etc. 

Life in the open air and free exposure to the 
vivifying influence of sunlight are among the best 
blood-restoratives, but must be under genial cli- 
matic conditions, for such patients fear cold and 
bad weather. Massage also may be added to the 
hydrotherapy. 

The traveling and change of scene and climate 
are useful adjuncts in the cures recommended abroad. 
Inhalations of oxygen, and baths of compressed air, 
are used for anaemia and chlorosis at some of the 
European stations. 



— 32 — 

The high-air cures, Davos and St. Moritz, may be 
added for those who enjoy cold, bracing air. 

Anasarca. — See Dropsy. 

Ankylosis. — In fixed joints the very hot applica- 
tions of mud and sulphur- waters are best. Dax, St. 
Amand, Aix, Bath, Malvern, Teplitz, Loeche; Baden 
in Switzerland; Acqui in Italy; Wildbad in Germany. 

There is no question that such waters often pro- 
duce effects which in ordinary surgery would be con- 
sidered surprising; where there is a complication with 
scrofula or tuberculosis the salt waters are import- 
ant aids. Salins-Moutiers, near Brides-les-Bains, in 
France, and Droitwich in England, are types of this 
class of waters. 

Electrical applications to the muscles are often 
added to the treatment. 

Anthrax. — See Carbuncle. 

Aphonia. — See Throat Diseases. 

Aphthce. — Vichy and alkaline waters. 

Apoplexy. — See Cerebral System. 

Arteriosclerosis. — Marienbad, Carlsbad, Brides, 
Tarasp, for the corpulent; Vichy, Neuenahr, Baden- 
Baden, Royat, Kissingen, for thin patients. 

It is, of course, understood that I do not give 



— 33 — 
the drug treatment of diseases, but only the climatic 
or water-cure indications as far as possible. Some 
waters contain a certain portion of salts such as 
sodium iodide, etc., but not in sufficient quantity to 
be looked upon as regular drug or medicinal treat- 
ment, which we agree that nothing can replace. 
Drugs themselves can be had anywhere, but one can- 
not get everywhere the rules of hygiene carried out 
as can be done with ease at mineral-water stations. 
Here the patients will conform to early rising and the 
judicious regimen sanctioned by experience, so that 
the dormant energy of the system held down by dis- 
ease awakens, not only because of the waters, but 
because the lungs have been filled with pure air, and 
the great arteries which go to the lungs and to the sys- 
tem generally become enlarged so that they distribute 
a larger, ampler current that assists greatly in cure, 
and makes the chances of its being complete better 
than by the usual drug treatment carried out at home. 

Ascites. — Mineral waters are contra-indicated, but 
the warm winter residences will be useful. 

Asthma. — It is truly said that these patients can 
find places where they are better off than at others; for 
instance: some of them do well on heights, the oxy- 
gen of the air seeming to help them; others do well 
in plains or at the sea-side; so that the indications 
vary greatly. Mont Dore, Cauterets, Eaux Bonnes, 

3 TTT 



— 34 — 
Meran, St. Moritz, Scarborough, Malvern, La Bour- 
boule, Schinznach, Allevard, Royat, St. Honors, En- 
ghien, Brighton, Bournemouth, Ems, Montreux, Nice- 
Cimiez, San Remo, Pau, Grasse, Glion, Biarritz, 
Arcachon, Lugano, Hastings, Weybridge, Pine Woods. 

To make a choice among these places I should 
say that the arsenical waters of Mont Dore and La 
Bourboule in the centre of France suit a large number 
of cases, who breathe better in such high places. 

To patients who prefer the air of the plains, and 
who are besides arthritic, Vichy is useful. The 
lymphatic cases do best in the hot sulphur-water 
stations. Cauterets, in the French Pyrenees, for a 
high mountain place of this kind with hot springs; 
and Enghien, close to Paris, for a cold sulphur-water 
treatment in the plains. It is very strange and to be 
remarked that certain asthmatics can live in perfect 
health in the close air of large cities, whilst a journey 
to the mountains or sea-shore brings on their attacks. 
The converse is true, and they must search for the 
place where they can enjoy immunity from attacks, 
be it plain, sea-side, or mountain. 

Atrophy. — Dax, Aix, Baden-Baden, Bath, Lama- 
Ion, Salies de Beam, Loueche, Schwalbach, hydrop- 
athy. 

In the rare cases where the first cause of muscu- 
lar atrophy can be found out, of course the appropri- 
ate medical treatment should be used. For instance, 



— 35 — 

if syphilis is suspected, the mixed medication, and so 
on. In many cases of atrophy a spinal origin is 
diagnosticated, and electricity (with galvanic current) 
is applied directly to the spinal column. 

When, however, the atrophy is of a myopathic or 
neurotic order, the induced current is applied, either by 
faradization of the muscles, or what is called general 
faradization. Electric baths are also recommended. 
The treatment in all cases is a very long one, and 
massage, douches, and all the different forms of 
hydrotherapeutic treatment, can be well combined 
with the electricity — which is given, as before stated, 
in almost all the bathing establishments abroad. 

Bladder {Diseases of). — Catarrh: Contrexeville, 
Vittel, Evian, Amphion, Thonon, Pougues, Vichy, 
Royat, Brides, Tarasp, hydropathic cures. 

Cystitis: The above and Neuenahr, Bath; hot 
baths of all kinds. 

Incontinence of Urine: Neris, St. Sauveur, Plom- 
bieres. 

Warm climates in winter are useful for bladder 
troubles. 

Stone: Vichy, Royat, Pougues, and a few other 
stations have made small stones pass. 

It has been advised to change climate in all cases 
of calculi; most writers believe that such change has a 
very powerful influence over the formation of concre- 
tions in the bladder. But so many difficulties arise in 



- 36 - 

judging this matter, in reference to change of water, 
diet, etc., that we can hardly form a just estimate of the 
value of change in preventing the occurrence of these 
disorders. It cannot be doubted, however, that the 
tendency to the formation of calculi will be less likely 
to arise in a climate where the patient enjoys com- 
parative health, and where the tone of his diges- 
tive and assimilative powers is fairly maintained. 
The mineral waters of Vichy, Carlsbad, Royat, Pou- 
gues, and others have always been reputed efficacious 
in the reduction of these formations. I cannot say 
they have the power to dissolve them, but I have 
constantly seen patients pass stones after a few weeks' 
treatment at these stations, and every physician who 
has practiced for a certain time at these watering- 
places has a collection of calculi. 

Boils and Carbuncles (disposition to). — A urine- 
examination should be made first in such cases. 
Uriage, Aix, La Bourboule, Schinznach, Carlsbad ? 
Mont Dore, and many of the sulphur waters. 

It is the duty of all physicians to search the med- 
ical history well of all patients who are subject to 
boils or carbuncles. It is probable that they will 
often find albuminuria, diabetes, or some of the or- 
ganic degenerations. The salt and also the sulphur- 
ous waters have long been used with success in these 
troubles, but of course the causal or actual disease 
must be met by treatment appropriate to it. 



— 37 — 

The arsenical springs at La Bourboule, when there 
is any sugar in the urine, are most useful in cases of 
boils. 

Bright 's disease. — See Albu?ntnuria. 

Bronchitis [chronic). — Ems, Cauterets, Challes, 
Marlioz, La Bourboule, Eaux Bonnes, Luchon, St. 
Honore, Allevard, Royat, Mont Dore, Soden, Pyr- 
mont, Schinznach, Ischl, Plombieres. 

Climatic Treatment: When there is much mucous 
discharge, try the dry tonic climates, such as Nice, 
Mentone, Cannes, St. Remo; when of the dry, hack- 
ing form without discharge, the more moist mild 
climates, such as Pau, Algiers, Tangiers, Madeira, 
Meran, Montreux, Torquay, Hastings, Isle of Wight, 
Arcachon, etc. 

In giving the above list of mineral waters and 
climates as the most recommended ones in bronchial 
troubles, I need hardly say that all bronchial and 
laryngeal affections are amongst those that derive the 
most benefit from change of climate. It is also, of 
course, understood that it is only in their chronic 
forms that these remedial agents can be brought to 
bear upon them. All chronic bronchial cases whose 
malady recurs every winter, should break this ten- 
dency by starting south by the end of September. 

The English climatic resorts, such as the Under- 
cliff, Clifton, Brighton, Worthing, Torquay, Queens- 



-38- 

town, are only suitable for those patients of a nervous 
temperament who have a dry, sensitive condition of 
the air-passages, with very little or no expectoration. 

The moment there is a catarrhal or mucous dis- 
charge, it is only the dry tonic and exciting-air cli- 
mates that are of use. Egypt should be added to the 
above for those who can afford the long journey there 
and consequent expenses. 

A summer tour to the watering-places is indi- 
cated after the winter climatic treatment, when a 
careful course of mineral waters can be taken to 
great advantage. 

The long list of invalids who suffer from an un- 
usually sensitive mucous membrane of the larynx and 
bronchi, especially elderly persons, is immense in the 
south of France every winter. The mild air here 
permits of their gradually becoming accustomed to 
the out-door air, and the younger ones of this class 
get a new lease of life and probably prevent worse 
troubles by leaving the raw air of their homes. Many 
people look upon the Mediterranean coast as their El 
Dorado; and why some of them prefer one place and 
some another is difficult to find out, when the climate 
in all the stations is so very much alike. Clear from 
Pau to Pisa there are some thousand health resorts, and 
each one of them counts a solid constituency of suf- 
ferers from bronchial troubles who swear by a certain 
place, and utterly abhor the others, quite near by. It 
is probable that some slight protection and local agree- 



— 39 — 

able surroundings, rather than any difference in the 
condition of the different patients' bronchial tubes, 
make this preference. 

All those who suffer from diseases of the larynx 
had better spend the winter on the Riviera than any- 
where else. Common sense teaches us that an organ 
so delicate and so directly accessible to the outer air 
as the larynx, is more easily irritated and injured by 
a cold climate than by a mild one. 

Burns. — Vichy and the hot alkaline waters. Any 
prolonged baths for old burns. 

Calculi [biliary). — Vichy, Pougues, Royat, Mari- 
enbad, Carlsbad, Vittel, Contrex£ville, Ems, Evian, 
La Porretta, Franzensbad. (See under Bladder). 

In addition to the treatment so often successful 
at Vichy, Carlsbad, and similar stations as indicated 
above, great importance is given to milk treatments 
abroad, as well as life in the open air, with a great 
deal of exercise or massage. 

Cancers. — Of course not much can be done in 
such cases, but a certain amount of relief from pain 
can be got at hot alkaline springs, such as the "grande 
grille " at Vichy. The sulphur waters are harmful in 
cancer, being too exciting. 

Carbuncle. — See Boils. 



— 40 — 

Catarrhs. — Chronic intestinal: Brides, Carlsbad, 
Bath, Cheltenham, Homburg, Marienbad. 

Nasal: See Rhinitis. 

Pulmonary: See Phthisis. Eaux Bonnes, Cau- 
terets, Marlioz, Aix-les-Bains, Ems, Royat, La Bour- 
boule, Meran, Mentone, San Remo, Beaulieu, and all 
the winter climates. 

Urethral: The alkaline waters, Vichy, Pougues, 
Ems, Kreuznach. 

Uterine: See Uterus. 

Catarrhs are the most common disorders of all 
the mucous membranes, and when in a chronic 
stage are most difficult to cure promptly and surely. 
There is perhaps nothing so efficacious as change 
of climate during convalescence from influenza. 
This catarrhus epidemicus leaves so many obscure 
debilitating disorders after it that frequently the 
only remedy left to quell the long-lingering effects 
is to send the victim abroad, where a complete 
change prevents these complaints going into some 
of the chronic forms of disease that may be ac- 
companied by complications of a dangerous nature. 
If influenza takes the intestinal form, or if there is 
any catarrh of the intestines, Brides les-Bains in 
France offers a good form of treatment, also Carlsbad 
or Marienbad in Austria, and Cheltenham in England. 
The urethral catarrhs are treated at the hot alkaline 
waters best, such as Vichy, For bronchial catarrhs, 
Cauterets and Eaux Bonnes, in the Pyrenean Moun- 



— 41 — 
tains on the Spanish border of France, are celebrated, 
while Ems is perhaps the best place in Germany. 
The waters in France mentioned are of the sulphur- 
ous class, while Ems is an alkaline water like Royat 
in France. 

Cerebral System. — Some resorts treat brain and 
spinal troubles: Lamalou and Balaruc, in France, 
claim good results, and Carlsbad, Gastein, Ragatz, 
Wildbad and Plombieres treat such cases. They are 
not suitable to most of the mineral springs, but are well 
managed at the hydropathic establishments — Divonne, 
Champel, etc. These cases should not be sent to the 
tonic exciting climates of the south of France, such 
as Nice, Cannes, and the whole Riviera. They might 
suit at Pau and the more damp, sedative resorts, like 
Madeira. (See Locomotor Ataxy?) 

Chlorosis (see Anozmia also). — Spa, Pyrmont, 
Schwalbach, Royat, Plombieres, Meran, St. Moritz, 
Clifton, . Malvern, Homburg. All the water cures. 
Forges, Neris, Greoulx, St. Sauveur, Pougues, Bour- 
bon, La Bourboule. 

Anaemia, chlorosis, and general cachexia are 
closely allied; they are characterized by a vitiated 
state of the blood, arising in many ways and differing 
in each state as to the lesions of the blood-globules, 
but they may be appropriately spoken of here, for in 
all of them change of air, outdoor moderate exercise, 



— 42 — 

well ventilated rooms, cheerful scenery, sunlight, 
amusement, are indicated. 

Of course, when they arise from insufficient or 
improper food, bad ventilation, want of exercise, 
abuse of alcoholic liquors or even drugs, syphilis, ex- 
hausting forms of business, debilitating' discharges, 
imperfect menstruation, each of these causes must be 
met with a judicious exhibition of alterative and tonic 
treatment; but gentle traveling, mineral-water treat- 
ment at an iron spring, with residence in bright, 
sunny, dry climates in winter, such as Nice and the 
whole French and Italian Riviera, may be recom- 
mended with the greatest confidence. 

All the hydropathic establishments in Europe 
treat chlorosis, but it is best to try an iron-water as 
well. Spa in Belgium, and Schwalbach in Germany, 
usually head the list, while Plombieres and Royat in 
France combine an iron-water of a much weaker 
character with a combination of arsenic. Then. La 
Bourboule in France presents quite a strong arsenical 
water that has valuable indications in chlorosis. 
Meran gives a grape cure, but has no mineral waters. 
Its climate is bracing. 

Chorea. — La Bourboule, Levico, Plombieres, Aix- 
les-Bains, Baden-Baden. 

La Bourboule, in the Auvergne Mountains in the 
centre of France, is the strongest arsenical spring. 
Levico and Rousegno are in Upper Austria, and have 



— 43 — 
extremely strong arsenical waters which contain cop- 
per and other salts. 

Gymnastics, massage, and static electricity are 
favorite modes of treatment for chorea added to most 
of the watering-places abroad. Some of the estab- 
lishments try absolute isolation. 

Colic (hepatic). — Carlsbad, Vichy, Brides-les- 
Bains, Cheltenham, Harrogate, Marienbad, Chatel 
Guyon. (See Liver Diseases as well.) 

Capvern and Vittel, in France, should be added 
to the French stations treating hepatic colic, as well 
as Contrexeville. These waters, like Evian, also in 
France, act on the kidneys and the liver, but do not 
purge, while Carlsbad in Austria, Chatel Guyon and 
Brides-les-Bains in France, and Cheltenham in Eng- 
land, add a purgative action as well. 

Confinement (when difficult). — Any of the warm 
baths, and life in warm climates. Nice and the south- 
of-France places are excellent during labor, and tend 
to make it much easier. 

Constipation. — Carlsbad, Chatel Guyon, Brides, 

Montmirail, Cheltenham, Homburg, Leamington, 

Kissingen, Capvern, Aulus, Harrogate. The bottled 

waters, such as Hunyadi Janos, Pullna, Rubinat, Vil- 

acabras, Friedrichshall. 

For those who can travel as far as Budapest, in 



— 44 — 

Hungary, the excellent Hunyadi-Janos waters can be 
taken on the spot. This water is popular all over the 
world, but, like all waters, can be best taken on the 
spot. It is true that the purgative waters do not 
need to be as fresh as the other mineral waters con- 
taining gases. None of the waters in France are 
purgative, and but a few are laxative. Montmirail 
and Chatel Guyon are the strongest, and they require 
almost a quart to produce a purgatiive action in most 
people. Brides-les-Bains is also laxative, and Voriage 
slightly so. 

In late years, Rubinat, Villacabras, and Carva- 
bana w r aters from Spain have been introduced into 
France. They give a purgative action with quite a 
small dose, but do not seem as yet to displace the 
Hunyadi-Janos Hungarian water. Pullna and Fried- 
richshall are not so reliable, often require large doses, 
and their sate has much diminished in France and 
England. 

Contractions of Muscles and Tendons. — At hot sul- 
phur springs such as Aix-les-Bains, Dax, Marienbad. 
Massage given with the waters, as at Aix-les-Bains, is 
the best treatment. 

See description of the douche-massage, page n. 

Cough. — See Bi-onchitis. 

Convalescence. — All mountain and sea-side places. 
See Ancemia for mineral springs and climates. 



— 45 — 
Cystitis. — See Bladder Diseases. 

Debility. — Gastein and the cold-water cures have a 
reputation for nervous forms. See also Convalescence. 

Diabetes. — La Bourboule, Vichy, Brides-les-Bains, 
Teplitz, Carlsbad, Neuenahr, Clifton, Pougues, Vittel,. 
Droitwich, Contrexeville, Capvern. 

In the lighter forms, as well as the medium cases, 
the life in the open air, gentle exercise, walks, and 
freedom from intellectual work, combined with a cure 
at Vichy every year or one of the above mineral- 
water springs, can be recommended. 

French physicians make this distinction in pre- 
scribing waters: they say arthritic, gouty, or gravel 
cases that become diabetic in middle life, and that 
are robust still, do best at the alkaline waters, like 
Vichy, which often causes all the sugar to disappear 
from the urine; while those who are older and have 
begun to get thin, and are fatigued by their disease, 
will do better at Royat or at the stronger arsenical 
waters of La Bourboule. 

A moderately warm, sunny, dry climate, by in- 
creasing the activity of the skin and lungs, is sure to 
exercise a beneficial effect in such cases when aided 
by diet and a judicious regimen. 

The German doctors regard Carlsbad as a good 
cure, but only for the slighter forms of the disease. 
It is said to increase and maintain the tolerance of 



- 4 6 - 

the starchy foods by some special action on the 
hepatic cells. Carlsbad water does act on the liver 
probably, and this may be the cause of its good influ- 
ence in light cases of diabetes. 

Neuenahr in Germany also claims cures from its 
salt waters. 

Contrexeville in Northern France is advised for 
gouty diabetics. 

A well regulated diet treatment is also rigorously 
attended to much better when at mineral springs, 
where one has time to give the fullest attention to 
this important part of diabetic regimen. 

Dropsy. — Carlsbad, Cheltenham, Brides, Harro- 
gate, La Bourboule, Baden-Baden, Bagneres de 
Bigorre, Cauterets, the " Terrain Kurs." 

As dropsy is only a sign or symptom of many 
different diseased conditions, the cause of the ac- 
cumulation of serous fluid must be first sought for. 

See Bright 's Disease, Heart Affections, Ascites. 

Dysentery. — Carlsbad claims to treat this disease; 
and La Bourboule, with other arsenical waters, like 
Levico, may be useful if it comes from residence in 
malarial districts. 

Spa, the iron springs in Belgium, also has it on 
its list of cures. 

As many of these cases of chronic dysentery are 
found in patients coming from a life in hot^climates, 



— 47 — 
it is probable that the change of climate alone has 
much to do with the cure. In fact, it may be stated 
as an indispensable condition of cure that these 
patients must leave the place where they contracted 
the disease. 

Kissingen water in very small doses is claimed to 
be a cure, exerting a constipating action and favoring 
.gastric digestion. It is probable that all very hot 
waters are useful by an intestinal antiseptic or rather 
simply purifying action. 

Dyspepsia. — Acid form: Vichy, Vals, Royat, 
Neuenahr, Alet. 

Atonic form; Pougues, Homburg, St. Moritz, 
.Spa, Brides-les-Bains, Orezza water used at home. 

Painful: Plombieres, Evian, Amphion, Pougues. 

Flatulent forms: St. Sauveur, Niederbronn, Hom- 
burg. 

Catarrhal forms (with constipation): Carlsbad, 
Marienbad, Brides, Chatel Guyon, Tarasp, Kissingen, 
Harrogate, Leamington. 

Dyspepsia is one of the disorders, in the allevia- 
tion of which change of climate is preeminently suc- 
cessful. When arising from too close application to 
study or business, or indulgence in any depressing 
passion, or almost from any cause whatever when un- 
accompanied by organic lesions, it may without fail be 
improved, if not entirely cured, by judicious change 
-of air, regimen, and a proper course of waters. It 



- - 4 8 - 

will be essential, first of all, to secure an accurate 
acquaintance with each particular feature of the case, 
both of those that are apparent and others of a 
masked kind. Not infrequently these patients will 
lead a practitioner off the scent by insisting that they 
have heart disease, or else bronchial or pulmonary 
complaints of an obscure nature, whereas the symp- 
toms felt in the throat and chest may be, and often 
are, simply dependent on a disordered condition of 
the digestive apparatus. 

If the dominating symptoms are of an inflamma- 
tory type, a sedative climate should be recommended, 
such as Pau in France, or the resorts on the south 
coast of England. The dry tonic climates of the 
south of France are contra-indicated; but if the case 
belong to the atonic variety, then the dry stimulating 
climate of Nice will do wonders, and a winter spent 
in such a suitable climate, with the subsequent sum- 
mer at one of the mineral springs, will go far towards 
a permanent cure. 

Many persons, even physicians, suppose that 
courses at mineral springs such as Brides-les-Bains, 
Tarasp, and Carlsbad, are lowering; but, on the con- 
trary, they are tonic and health-restoring, producing 
results in dyspepsia with constipation that no so-called 
restorative drugs can. They wash out the intestines 
and remove all toxic accumulations, promote ab- 
dominal circulation, and stimulate the liver and the 
peptic glands. When the tendency is acid and more 



— 49 — 
to diarrhoea than constipation, then the more alkaline 
springs, such as Vichy and Royat, are more applicable. 

Dysuria. — In painful urination, Contrex6ville, 
Vittel, Evian, are advised in France, Ems in Ger- 
many; Homburg also would be useful. 

Here, again, before coming to a decision, we 
must search for the cause of the pain in urination, and 
treat it. 

Ear Troubles. — Brides-les-Bains has these on its 
list. It is possible that the action of hot baths may 
have some slight influence for good. 

Eczema. — See Skin Diseases. 

E?nphysema. — The dry mountain climates help 
distention of the tissues with gas. Meran, Madeira, 
San Remo, in Italy, and Cimiez at Nice, are advised. 

The mineral waters also give excellent results. 
Eaux Bonnes, Cauterets, Allevard, La Bourboule, and 
Mont Dore, in France. At Reichenhall, in Germany, 
inhalation of saline spray is combined with the pneu- 
matic-chamber treatment. 

It is probable that all the springs do good, not 
so much through the mineral water, but owing to the 
fact that they are situated in tonic air climates in the 
mountains, where, the ozone or oxygen being in- 
creased in the lung tissue, and the unused and com- 
pressed air-cells relieved, benefit is derived. 

4 TTT 



- 50 — 
Erysipelas. — Some of the chronic cases, and those 
subject to the disease, do well at hot sulphur-water 
springs, Aix, etc. 

Erythema. — The skin inflammations are much 
soothed at hot alkaline springs, Vichy, etc. 

Exophthalmic Goitre. — Hydropathic establish- 
ments are recommended for these complicated thyroid 
cases, where cold-water treatment can be combined 
with electricity. 

Eye Diseases. — These are very little if any aided 
by mineral waters. 

Fractures. — All old fractures do well at hot mud 
sulphur-baths. Dax, Bareges, Baden, Aix, Acqui, 
Salins, and hot salt springs. 

The treatment of old fractures at the hot sulphur- 
water stations has been recognized for many years in 
France as being of great value. In the time of Na- 
poleon I., large hospitals were built over the baths 
at Bareges, Vichy, Aix-les-Bains, and many other 
springs in this country, which are still kept up by the 
French Government, which yearly sends large num- 
bers of soldiers to be treated for fractures, stiff joints, 
etc. 

Gall- Stone. — See Colic {hepatic). 

Gastralgia. — See Dyspepsia {painful). 



— 5i — 
Gastric Catarrh and Ulctr. — See Stomach {Diseases 
of). 

Genu Valgum. — Aix, and the hot sulphur-waters 
where massage is given. 

Gleet. — Contrexeville, Vittel, Pougues. These 
waters act on the kidney, but it is doubtful if they 
would cure the local lesion. 

Gout. — Royat, Vichy, Dax, Teplitz, Marienbad, 
Eath, Aix-les-Bains, Homburg, Uriage, Brides, Carls- 
bad, Malvern, Harrogate, Baden-Baden, Cheltenham, 
Strathpeffer, Vittel, Nauheim, Kissingen, Evian (hy- 
dropathic establishments), Buxton, Ems, Leaming- 
ton, Pougues, Contrexeville. It must not be expected 
that any bath will resolve tophi. To the above 
mineral-water springs may be added Wiesbaden in 
Germany, as well as Aix-la-Chapelle, as they are fre- 
quently resorted to by persons of gouty disposition. 

Removal to a mild and dry climate in winter is 
usually followed by abatement in the frequency of 
the attacks in this disorder, if not by its removal alto- 
gether, when change of climate is resorted to at an 
early stage in the disease and when adherence to 
a proper regimen is rigidly observed. Of course, it is 
not during a paroxysm, nor even when an attack is 
imminent, that the change can be made, but when 
the patient is free from acute symptoms. 

In removing to a warmer climate, care must be 



— 52 — 

taken to regulate the diet in accordance with the 
habits of the country. The southeast coast of 
France, called " The Riviera," is usually considered 
to be the type of climate most useful and serviceable 
in these cases. Nice is perhaps the best place, unless 
the patient is also subject to chest complaints, when 
Beaulieu, or even Mentone, being more sheltered, 
would be advisable. 

The alkaline mineral-waters probably exert their 
beneficial effects through their action on the liver and 
alimentary canal. The gout cures at Carlsbad and 
all the stations embrace much more than drinking the 
waters, for they include exercise, bathing, diet, and 
many other things carefully attended to. 

Apollinaris water, which is sometimes recom- 
mended by English writers for gout, has no value. It 
is a simple drinking-water that is charged with gas 
by artificial means, and no one goes to its springs. 

It will be noticed that all kinds of mineral waters 
are recommended for gout. The hot ones are best in 
chronic rheumatic conditions, while Kissingen and 
Homburg salines are useful in chronic dyspepsia, 
Contrexeville and Vittel when the kidneys need work- 
ing, while the sulphur springs are best in the gouty 
constitution when it is accompanied by cutaneous 
eruptions. 

Drinking plenty of any hot water that has reached 
over boiling-point is a valuable remedy in gout, as it 
acts as a diluent and solvent of renal and other ex- 



— 53 ~ 

crementitious matters. This combined with hot baths 
keeps the skin in active order. These truths show 
that all the hot mineral-springs are useful in gout, as 
they hasten the complete metabolism of nutritive 
waste. It is considered highly beneficial to drink the 
hot sulphur-waters of Aix. English medical writers, 
speaking of the use of mineral waters, say that springs 
of the class of Aix have the advantage of being 
thermal, or hot, and act on the system by diluting 
the blood temporarily, and lowering the percentage 
of urates and sodium salts. This tends to retard 
uratic precipitation, and gives the kidneys time to 
overtake their arrears in the task of eliminating uric 
acid. 

Hcematemesis. — See Stomach (Diseases of). 

Hoztnatitria. — Contrexeville, Carlsbad, Spa. 

Hemoptysis. — See Phthisis. 

Hemorrhoids. — Carlsbad, Franzensbad, Brides, 
Vittel, Homburg, Kissingen, Moffat, Strathpeffer, 
Chatel Guyon. These are laxative waters that act in 
the usual way to relieve piles, but in the last few years 
what is called the perineal douche is given at Aix-les- 
Bains and other hot-water stations, to great advan- 
tage. This is combined with injections into the lower 
rectum of very hot water. This has a powerful effect 
for good, not only on piles, but on all the congestions 






— 54 — 

and hypertrophies of the lower bowel, with the ad- 
jacent parts. Prostatic troubles are wonderfully 
benefited by this form of treatment. 

Hay Fever. — The mountain stations: Cauterets, 
Luchon, Switzerland. 

Heart Diseases. — Nauheim, Aix-les-Bains, Bath, 
Baden-Baden, Pugny-les-Corbieres at Aix-les-Bains, 
are stations where the Oertel " terrain kur," or ascend- 
ing walks, are given, as well as Meran, Arco, and a 
number of the German health resorts. Nice and the 
Riviera in winter, and warm climates in general, are 
recommended in heart cases. Certain hydropathic 
operations would be harmful, but Aix-les-Bains claims 
with a few other stations that only good can come of 
a mild tonic form of mineral-water bathing treatment 
in many forms of heart disease. 

Hepatic Diseases. — See Liver {Diseases of). 

Herpes. — See Skin {Diseases of). 

Hydropathic Establishments. — In England: Mat- 
lock, Smedley's; Dr. Fergusson's at Malvern; Wyche- 
side at Malvern; The Mansion, Richmond Hill, Sur- 
rey; Tyndale, Hexham, Northumberland; The Hall, 
Bushey; The Somerville, St. Aubin's, Jersey; The 
Imperial, Harrogate. In Scotland: Deeside, Heath- 
cot, near Aberdeen; Bridge of Allan, near Stirling; 



— 55 — 
Philps, Dunblane, Perthshire; The Waverley, Mel- 
rose; The Edinburgh (Jas. Bell, manager). Champel 
in Geneva; Divonne, also near there. Gerardmer, in 
the vosges of France, is a good water-cure. Worisho- 
fen, in Bavaria, is Father Kneipp's home, while Jor- 
danbad, in Wiirtemberg, is on this system. In Paris, 
Dr. Beni-Barde, Rue Boileau 12, Dr. Duval, Rue 
Jacob 20, Dr. Descourtis, Faubourg St. Honore 108. 
and Dr. Keller, same street, 127, with Dr. Chevan- 
drier de la Drome, 47 Rue Pigalle, have excellent 
hydrotherapeutic establishments. There are many 
more of these water cures, but the above are a fair 
sample of them. It must also be remembered that all 
the mineral-water cures and stations, even the hot 
springs, have also a hydropathic system installed. 
They are all in mountainous countries, where they 
can get plenty of pure cold water in addition to the 
water coming from the springs; so it is made use of 
in cold douches and all the usual cold-water cures. 

Hypochondriasis. — Gastein, St. Sauveur, Matlock, 
Champel, Divonne. Hydropathic cold-water cures. 
The sunny winter places: Nice, Nervi, San Remo, etc. 

Hysteria. — Aix-les-Bains, Carlsbad, Franzensbad, 
Gastein, Spa, Bagneres de Bigorre, St. Sauveur, Mat- 
lock, Champel, Divonne. (See Hydros.) The bright 
winter climatic stations: Nice, Cannes, Monte Carlo. 

Hysteria and hypochondriasis are of those dis- 



- 56 - 

orders that traveling from place to place amongst 
bright sunny cities, like those on the Riviera, with 
cheerful society, improves constantly. The mineral- 
water indications are those of nervous forms of dys- 
pepsia: the dry, exciting, tonic atmosphere of Nice, 
with all its gaiety, moderate diet, gentle exercise, and 
careful attention to the healthy performance of the 
secretory and excretory functions, combined with 
bathing and massage. Italy in the spring, May and 
June (after the bad weather has been passed) at Nice 
or Cannes, for instance, is to be recommended, for the 
bright Italian cities are only a few hours apart, and 
there is so much to see in each of them to interest 
this class of patients that this trip should form part 
of every European tour. 

Impotence. — Aix-les-Bains, Chatel Guyon, Fran- 
zensbad, sea-sides, warm climate in winter, Nice, etc. 
Gastein, in Austria, claims to treat this trouble 
with great success. Indeed, most of the German 
watering-places place impotence on their list of cures. 

Inso?nnia. — Aix-les-Bains, Bagneres de Bigorre, 
mountain climates in general, Gastein, Wildbad, Mari- 
enbad, Franzensbad. The valley of Aix is very seda- 
tive, and sleeplessness is cured easily there. There is 
a marked difference between Aix and the Riviera as 
regards sleeping. Owing to the excellent atmospheric 
conditions, people rest well at Aix, while in the South 



— 57 — 
the exciting air tends to produce insomnia in nervous 
patients. 

Intemperance. — Alcholism is well treated in Eng- 
land in special water-cure establishments. I men- 
tion Tower House, Westgate-on-Sea, Kent; Dalrym- 
ple Home, Rickmansworth, Herts; High Shot House, 
St. Margaret's, Twickenham, Middlesex; Kingswoods 
Park, Gloucestershire, near Bristol; The Peak at 
Buxton. 

This question of the abuse of alcoholic drinks is 
not well discussed in medical works, and yet it is 
of the greatest importance. It has been forced upon 
the English by the intemperance of the citizens; 
living as they do on a damp island, they found they 
could take with impunity, indeed with benefit for a 
certain time, a quantity of alcohol. This, however, 
had a limit, and it was soon found to end in disease. 

Vichy and the hot alkaline springs abroad, of 
course, do good in these cases, which are often com- 
plicated by liver disorders. (See Liver.) 

Intermittent Fever (after attacks of, and those 
subject to). — La Bourboule, Levico, Homburg, Carls- 
bad. Sea voyage. 

The arsenical waters, as above, are the best of 
the mineral waters for this condition. 

Intestines (Atony of).-— Carlsbad, Chatel Guyon, 
Marienbad. 



-58- 
Intesti?ial Obstruction. — The same. 

Jaundice. — See Liver {Diseases of). 

Joints (Diseases of). — Aix-les-Bains, Dax, Teplitz. 
(See Rheu7?iatis?n.) 

Kidneys (Diseases of). — Milk and whey cures, 
and grape cures, which are given at nearly all the 
stations. (See Albuminuria?) 

In chronic nephritis after all inflammation is over,, 
send to Contrexeville, Vittel, Vichy, Royat, Pougues, 
Evian, Matlock, Tarasp, Amphion, Thonon. 

Change of climate may be successfully employed 
in several forms of renal disease which threaten to go 
on badly as a consequence of too close application to 
business so common in America, a deficiency of out- 
door life and exercise, a too stimulating diet, and the 
very common over-free indulgence in alcoholic. and 
other stimulating drinks. 

A warm and fairly dry climate, by increasing the 
activity of the skin and lungs, would exercise a bene- 
ficial effect in all such cases, especially when aided by 
a well regulated diet and judicious regimen. Evian is 
a very favorite water for such cases. It is nicely sit- 
uated on the French side of the Geneva lake (Lake 
Leman). 

Larynx. — See Throat (Diseases of). 



— 59 — 
Lead Poisoning. — Ofen or Budapest, Aix, Cau- 
terets, Brides. The elimination of lead can be hoped 
for by hot sulphur-waters, particularly when com- 
bined with massage under the water, as done at Aix- 
les-Bains, Bath, etc. 

Leucorrhoea. — Baden, near Vienna. Bagneres de 
Bigorre, Spa, Franzensbad, Plombieres, Aix-les-Bains, 
Ischl. 

Daily vaginal injections are arranged for in many of 
the baths in Europe. With this local treatment can be 
combined the effects of alkaline waters — iron springs 
or the sulphur ones, as may be needed. The hot 
alkaline baths, such as Vichy, with the internal use of 
one of its iron springs like " The Madame" for drink- 
ing, is often successful in cases taken early. The 
sulphur-waters, such as Baden-bei-Wien, Bagneres, 
Aix, as well as Franzensbad and Ischl, are more used 
for old or chronic cases to get the stimulative effects 
of the sulphur- water on the mucous membranes. 

Spa and Schlanganbad are more used for the 
medicinal effects of iron-waters on the anaemia or 
chlorosis that may be present with the " whites." 

The salt waters said to contain iodine — Hom- 
burg, Soden, Salins-Moutiers — are given when scrof- 
ula is suspected. 

Liver {Diseases of). — Carlsbad, Ems, Vichy, 
Brides, Montecatini, Pougues, Clifton, Panticosa, 



— 6o — 

Royat, Malvern, Leamington, Cransac, Harrogate, 
Cheltenham, Marienbad, La Bourboule, Bourbonne. 

Carlsbad and Vichy are the most popular springs 
for cases of liver complaint, but the mere word 
" liver" does not define accurately what the disease 
may be the patient has. When there are any symp- 
toms of hepatic colic, for instance, the waters like 
Evian, Vittel, or Contrexeville are more often used 
than Carlsbad or Vichy. 

Congested liver, with or without enlargement, is 
certainly treated advantageously by such waters as 
Carlsbad, Marienbad, and Tarasp, while almost simi- 
lar effects can be got at Kissingen and Brides, in 
France; Harrogate, Cheltenham, and Leamington, in 
England, have a certain purgative action that is use- 
ful; and a number of cases are benefited by ordinary 
sulphur-waters, but, as a rule, waters containing purga- 
tive salts are used. 

Cirrhosis in early stages, before the organism 
breaks up, is often treated with benefit at the salt 
wells which contain iodine. For waxy, amyloid livers, 
and fatty liver in the strong, Vichy may be tried, or 
even Carlsbad; but the moment these patients become 
weak and anaemic, then chalybeates should be intro- 
duced: the waters of Brides, Royat, and La Bour- 
boule in France, Spa in Belgium, and Ems in Ger- 
many, may be tried then to advantage. 

Locomotor Ataxy. — Lamalou, in France, and Ba- 



— 61 — 

laruc claim cures. Uriage, Aix-la-Chapelle, Aix-les- 
Bains, Gastein, Wildbad, Ragatz, Nauheim, Neris. 
Bushey and Bath treat such cases. In winter they 
are sent to warm climates — Nice, Cannes, Nervi, San 
Remo, etc. 

As tabes is nine times out of ten of syphilitic 
origin, it is logical to give anti-syphilitic treatment, 
and one of the best means of having it tolerated is to 
give it in hot sulphur-water douches, like those of 
Aix-les-Bains in France, and Aix-la-Chapelle in Ger- 
many. 

Besides this action, Lamalou and Balaruc, in 
France, are stations near Marseilles that claim won- 
derful effects of a specific nature. Some of the 
French professors send their patients to these places 
every year. Neris, in France, is also a watering-place 
that is said to possess special virtue in nervous cases. 

Lumbago. — Bath, Aix, Baden-Baden, Marienbad, 
and all the hot springs. 

Beyond question, massage under hot water will 
cure chronic cases of lumbago. 

Malaria. — La Bourboule, Levico, Brides, Bath, 
Aix, sea-side and hydropathic establishments. 

The arsenical waters like La Bourboule and 
Levico have the double advantage of being medicinal 
and being in a high mountain country. The first is 
in the famous Auvergne Mountains, in the centre of 



— 62 — 

France, and the second is a very strong arsenical 
water in the Austrian Tyrol. Naturally, change is of 
great value in malaria. The hydropathic establish- 
ments giving cold-water cures help the condition 
with all their hygienic treatment and the healthy sur- 
roundings which are generally to be found there. 

Metritis. — See Uterus. 

Myalgia. — Aix, and all the hot springs where 
massage is used. 

Neuralgia and Neuritis. — Aix-les-Bains,* and the 
hot sulphur baths when from rheumatism. The cold 
ones when arising from nervous disturbance. 

The triumph of massage under hot water is seen 
in neuralgias at Aix, and at Bath in England, while the 
excellent cold-water cures can do great good in neu- 
roses. 

Neurasthenia, Nervous Debility, Neurosis (see 
Hydropathic Establishments). — Gastein, Alvaneu, cold- 
water cures, Neris, Lucca, Levico, Pyrmont, Mal- 
vern, Spa, Teplitz, Aigle, Plombieres, St. Sauveur, 
Ems, Droitwich, Baden, St. Moritz, Marienbad, Rip- 
poldsau, Salins, Divonne, Champel. 

Dr. R. Vigoureaux, of Paris ; has lately studied 
this condition, and he claims that it is an outcome of 
arthritism. In a word, the neurasthenics are rheu- 



- 63 - 

matics, and he proposes that they should be treated 
in water cures by warm baths of long duration (one 
to three hours), to combat the general erethism and 
insomnia; with this massage, and, above all, static elec- 
tricity. He adds bicarbonate of soda in large doses to 
^overcome the acid condition of the blood found in 
arthritic subjects, and excludes all other medication. 
He thinks the alimentation should only be sufficient 
for the actual needs of the system, and does not ap- 
prove of over-feeding. If it be so that the neuras- 
thenics are rheumatics, then the well known results 
at Aix-les-Bains of massage under the hot sulphur- 
water can be tried, and the after-cure at an alkaline 
station like Vichy would be useful. 

For nervous diseases the climate of the Mediter- 
ranean Coast has, according to different writers, as 
many disadvantages as virtues. Some physicians 
have taken the course of simply forbidding the Riviera 
for all their patients who have disordered nerves; but 
such a sweeping condemnation is by no means de- 
served. . 

Experience has taught us that epileptics should 
not go to Nice, and the morbid condition of such 
-patients, as their stay is prolonged there, gets worse 
and worse. 

Hysteria often seems incompatible with our pres- 
ent view of it as a mental disease, and all cerebral 
forms should be excluded but hypochondria. Neural 
-asthenia of spinal origin, locomotor ataxy without 



- 6 4 - 

insomnia, all the neurotic disorders of the stomach 
and intestines, neuralgia of peripheric origin, espe- 
cially in elderly persons, have so frequently shown 
decided improvement that attention must be called 
to the fact. I have been often struck with the good 
results in neurotic uterine and ovarian troubles and 
in many troublesome neuralgias. 

The rapid transition, by the express trains now in 
use, from the North, makes it only natural that some 
functional disturbance of the nervous system should 
occur in many people on first coming to the exciting 
air of the South, but only a short time in it will show 
the beneficial influence of the tonic climate. 

Nose {Diseases of). — See Rhinitis. 

Obesity. — Brides-les-Bains, Marienbad, Carlsbad, 
Aix-les-Bains, Pugny-les-Corbieres at Aix for ascend- 
ing walks. Kissingen, Arco, Meran, Bath. 

The regular recommendation of massage and 
muscular exercise, with a certain regimen, is what is 
always prescribed in obesity, and to this can be added 
a mineral-water treatment. In the strong, the purga- 
tives of Carlsbad and Marienbad in Austria. In the 
weaker, the laxatives of Brides-les-Bains in France, or 
Chatel Guyon. Certain acute cases do well under an 
alkaline treatment, like Vichy in France. 

All of these places have good walks for exercise. 
Aix-les-Bains has the massage underwater, which is a 



- 65 - 

ten-mile walk in each bath, and has the advantage of 
exercising muscles that cannot be moved by ordinary 
walking up or down hill, or even by gymnastic exer- 
cises. 

All the stations have milk cure, and fencing, lawn- 
tennis, and other exercises. 

Paralysis. — Agitans: Massage at Aix-les-Bains 
useful. The cold-water cures. 

Cerebral form: Lamaiou, Balaruc, Gastein, Nied- 
erbronn, Malvern, Acqui. 

Spinal form: Wiesbaden, Schinznach, Gastein, 
Mont Uore, Neris, Plombieres. 

Rheumatic forms: Aix-les-Bains, Neris, Acqui, 
Bath, Valdieri, Harrogate, Baden-Baden. 

Lead forms: Cauterets, Luchon, Aix-la-Chapelle, 
Uriage, Ofen, Dax, Bath. 

Senile forms: Balaruc, Lamaiou. 

Hysteric: Ems, Plombieres, Aix. 

Syphilitic: Aix-la-Chapelle, Aix-les-Bains. 

Climatic Treatment: Nice, Cannes, Mentone, etc. 

It would require a large book to write up the 
different forms of paralysis and their treatment at the 
European Spas. The above is a fair selection of the 
places treating the various forms, and in a general 
way they all do well at hot baths where a systematic 
massage of the paralyzed muscles or nerves can be 
carried out. Even hemiplegia is claimed to be cura- 
ble at Lamaiou, in France, while the cold-water estab- 



— 66 — 

lishments certainly do good in nervous forms. Lead 
forms are best sent to the hot sulphur baths. 

They all do well in the warm climates in winter. 

Phthisis. — The question of treatment of these 
cases is a very complicated one. The best general rule 
is as stated under " Winter Resorts : " " That the cli- 
mate that affords the greatest facilities for passing the 
greater portion of the time in the open air is the best 
one for such patients." An ocean journey is good in 
mild weather, and a few places are recommended in 
England, when the patient cannot go farther, such as 
Penzance, Hastings, Torquay, and Ventnor. Glen- 
gariff and Rostrevor may be considered in Ireland, 
and Rothesay in Scotland. The dry climates have 
constantly proved of the greatest benefit to consump- 
tives, such as Mentone, Tangiers, Morocco, Egypt, 
The Cape, Australia, Malaga, Madeira, San Remo, 
Reaulieu, near Nice, Ajaccio in Corsica, Alassio, 
Amelie-les-Bains. Arcachon, or Pau, would do in 
autumn, but not later. Next the high altitudes, cold 
sunny places, Davos-Platz, St. Moritz, Pontresina, 
Arco, Meran, Gardone-Riviera. The Denver, Colo- 
rado, sanataria are excellent also. A word must be 
added for the air cures, Gorbersdorf, Falkenstein, and 
Vernet, with Pugny in France. As to mineral-water 
treatment in summer: Eaux Bonnes, Ems, Mont 
Dore, Cauterets, Ischl, La Bourboule, Royat, Marlioz, 
St. Honore, Allevard. 



-67 — 

It is difficult to explain the exact situation of 
each health resort in Europe in regard to the indica- 
tions for consumptives. The principles I have laid 
down are contained in the newer phthisis-therapy, so 
successfully used in Germany. I mean the air cure. 
Life in the open air, day and night, can be well carried 
out even outside of the great institutions, and perhaps 
much better where there is not an accumulation of 
fellow-sufferers. This may be done in small hotels 
and boarding-houses, the "Pensions" of Southern 
France, where all the system may be practiced under 
careful medical direction. I have often seen active 
consumption reduced to a stationary condition in the 
South, in the presence of favorable circumstances, 
with proper hygienic and dietetic treatment. 

The consumptive who has been ill for years drifts 
slowly into aerophobia in spite of all treatment and 
strengthening diet. He stays in the house more, 
oxidizes his blood less, and gets into bad ways; and 
just here an anatomical factor belonging to nature's 
healing forces comes in to reinforce the enemy. The 
beneficent efforts of nature to hem in the seat of the 
disease with protective walls in such a way as to" 
isolate it, causes the formation of stringy scars in the 
diseased lung, of flat and filamentous adhesions in the 
pleura, and by thus cutting off portions of the breath- 
ing surface it diminishes it. From these, nature's 
healing operations, more imperfect oxidation takes 
place, with some obstruction of the circulation. Such 



patients revive in the South, where the warm sun and 
air tempt them out of doors. The cold mountain cli- 
mates are beyond their power of assimilation. 

Of course the residence in Southern France is not 
to be a permanent one; and as it is only provisional, 
the object of renewed adaptation to the conditions of 
the home life must be kept in view by patient and 
physician, and all efforts be made to have the patient 
get well enough to take up the healthy mode of life 
at home. 

Pleurisy (chronic). — Eaux Bonnes, St. Honore, 
Mont Dore; the warm climates in winter. 

Pleurodynia. — Aix-les-Bains, and hot waters in 
general. 

Pneumonia. — After-treatment: The warm cli- 
mates in winter, and the sulphur springs the next 
summer. 

Potfs disease. — Salins, Meran, sea-sides. 

Psoriasis and Prurigo. — See Skin Diseases. 

Rheumatism. — Simple chronic forms: Aix-les- 
Bains, Bath, Dax, Buxton, Acqui, Woodhull-Spa, 
Nauheim, Salins, Droitwich, Baden, Teplitz, Luchon, 
Cauterets, Malvern, Plombieres. Mud, pine and sand 
baths, Marienbad, and most of the hot springs — best 



— 6 9 — 

where the " massage-douche" is given, as at Aix- 
les-Bains. 

Rheumatism with nervous diseases: Neris, St. 
Sauveur, Bath, Plombieres, Tarasp, Matlock. 

With gout: Royat, La Bourboule, Pougues. 

With gravel: Vichy, Vittel, Carlsbad, Wiesbaden. 

With bronchial catarrh: Mont Dore, La Bour- 
boule. 

With skin disease and syphilis: Aix-la-Chapelle, 
Aix-les-Bains, La Bourboule. 

With deformed and fixed joints: Dax, St. Amand, 
Marienbad, mud baths. 

The climatic treatment is, of course, mild cli- 
mates, such as Nice, Cannes, Mentone, San Remo. 
Egypt sometimes, but in this case they must not stay 
in Alexandria or near the damp coast. Cairo is best, 
or up the Nile. 

There is no question but what persons afflicted 
with rheumatism should seek warm climates in win- 
ter, never the mountains. The residues of acute 
rheumatism of the joints are most rapidly cured in 
the south of France. The results are less certain in 
chronic rheumatism, but the comfort obtained is 
valuable to the sufferers. The chronic forms of rheu- 
matism assume so many disguises that we often have 
to call it a nervous debility more than real rheuma- 
tism. 

We constantly see cases of arthritis deformans 
that remain stationary in the South, and yet it will be 



— 7 o — 

admitted that this disease is a notoriously progressive 
one in the North. 

Rhinitis {Chronic Nasal Catarrh). — When in pas- 
sive, depressed patients, the sulphur-waters: Cau- 
terets, Luchon, St. Honore, Marlioz, Challes, Alle- 
vard. 

In nervous patients, the alkaline springs: LaBour- 
boule, Mont Dore, Royat. Ems. Climatic treatment 
is effective; I know of nothing better than the dry-air 
places of the south of France, where we have con- 
stant success in post-nasal catarrh. Nice, Mentone, 
etc., but more than one season's residence is necessary. 

Sciatica. — Aix-les-Bains, • Bath, Buxton, Teplitz, 
St. Sauveur, Woodhull-Spa. Dry mild winter climates 
in winter. Nice, Cannes. One author claims Monte 
Carlo to be particularly good for such cases, winter 
and summer. 

Skin Diseases. — Acne: Luchon, Aix, Ems, Schlan- 
genba.d, Tarasp, Schinznach, La Bourboule, Harro- 
gate, Ardales. 

Eczema: Uriage, Kreuznach, Salins, Aix, Levico, 
Royat, Acqui, Cauterets, Kissingen, Bath, Lisdon- 
varna. 

Lupus: Ofen, Budapest, Eaux Bonnes, Levico. 

Psoriasis: Nauheim, Bath, Levico, Harrogate. 

Prurigo: N£ris, Luxeuil, Aix. 



— 7i — 

Tinea sycosis: Sea baths, Salins. 

Urticaria: Kissingen, Franzensbad, Moffatt, 
Vichy, Aix, Neris. 

The skin diseases are mostly sent to sulphur 
baths as above; but taking eczema alone, it will be 
seen that the sulphur-waters of Aix, Uriage, and Cau- 
terets, in France, are recommended, and then the 
arsenical alkalines, like Royat and La Bourboule, meet 
other cases, while the salt springs, like Salins in 
France, are also given. To say just why and when, is 
extremely difficult. I have seen Luchon tried in 
one case and do no good, although a strong sulphur- 
water, and Aix, a weak spring, accomplish a cure 
in connection with massage. It may be stated that 
the sulphur-waters are best in the scaly cases without 
much pain, and the alkaline when pain is consider- 
able. Lupus is treated at Eaux Bonnes, and Buda- 
pest in Hungary claims results. The very strong 
copper and arsenical waters at Rousegno and Levico, 
in upper Austria, are also claimed to be curative in 
this disease. Acne is treated at Aix; also Urticaria, 
though this last does best at Vichy when from a 
stomach cause. 

Here again, in all these complex cases, we come 
back to the question, What is the cause ? in all the dis- 
eases, and particularly so in skin complaints, admit- 
ting, for instance, the so-called three-fold etiology of 
urticaria or nettle-rash. If it be from a nervous 
cause, then Neris, in France, or Kissingen, is the best 



— 72 — 

cure. If from the digestion, then Vichy and the 
places mentioned under Dyspepsia. If from some 
female irregularity, then the hot sulphur-waters 
with massage, as at Aix, Savoy in France, or Fran- 
zensbad in Austria. 

Spermatorrhoea. — Gastein, Cauterets, Allevard, 
Marlioz, Neris, Balaruc. 

Sprain. — Aix-les-Bains, and hot sulphur-waters, 
with massage. 

Sterility. — A number of the hot springs claim 
(doubtfully) to cure this condition. The massage- 
douche may be useful. Aix-les-Bains, Franzensbad, 
Ems, Pougues, Marienbad, Schwalbach, Spa, and 
iron-waters. 

Stomach {Diseases of). — Vichy, Homburg, and 
the gaseous alkalines, grape cures, Voslau, Kissingen. 

Gastralgia: Plombieres, Roy at, Evian, Homburg, 
Pougues. 

Dilatation: Carlsbad, Chatel Guyon, Aix. 

Catarrh: Carlsbad, Chatel Guyon. 

Ulcer: Vichy, Ems. 

Under Dyspepsia I have given some of the indi- 
cations for these stomach complaints in a general 
way. Hyperacidity and hypersecretion of the gastric 
juice are, of course, the two most common forms of de- 



— 73 — 
rangement of the gastric organ, while mere neurotic 
atony does not produce a loss of function and must be 
treated differently. 

A great distinction must be made between Vichy 
and Homburg, as the first is an alkaline water and 
the second a saline. 

It is probable that by drinking large quantities 
of alkaline water, or, indeed, any warm water, the 
bile will flow more readily and in greater attenuation, 
but the old dogma of some specific action of alkalines 
on the secretion of bile is no longer believed. The 
mild salines like Homburg seem to have an excellent 
action in many stomach cases, owing to their power of 
quickening gastric digestion. 

This subject is too vast to be entered into here. 
The hint is thrown out to wash out the stomach, and 
use the new chemical tests before making a diagnosis 
and giving advice. 

Strumous Affections. — First period (children 2 to 
10) : Sea-sides, Arcachon, Biarritz, Cannes, Nice, Berck. 
Then the salt springs: Salins, Uriage, Nauheim, Ischl. 
Second period (10 to 20, adolescents) : Salies de Beam, 
Salins, Ischl, Nauheim, Valdieri, La Porretta, Soden. 
Third period (adults): Then the hot sulphur-springs: 
Luchon, Cauterets, Aix, Baden, Eaux Bonnes, St. 
Honore, Enghien, Acqui, Kreuznach, Marienbad, St. 
Moritz, Woodhull-Spa, Harrogate, Ischl. See Tuber- 
culosis. 



— 74 — 

Syphilis. — Aix-la-Chapelle, Aix-les-Bains, Uriage, 
Archena, Saxon, Harrogate, and sulphur-waters in 
general, but the constitutional treatment must not be 
dispensed with. 

Aachen, as Aix-la-Chapelle is called in Germany, 
has a well deserved reputation in syphilis. The Ger- 
mans believe in rubbing in mercury just before the 
baths, and have men trained for the purpose. It is 
not easy to get patients themselves to rub the lanolin 
ointments, or the regular blue one. The lanolin 
makes them very black, and they have difficulty in 
getting it off, so that when it can be ordered to be 
rubbed in by the bathmen it is probable that a better 
treatment can be carried out in a systematic way in 
such resorts as Aachen. On the other hand, it has 
got to be so well known now as a bath for the treat- 
ment of what a witty writer there calls "suppressed 
rheumatism" that Aix-la-Chapelle is feared by the 
knowing ones. 

In the French Aix-les-Bains, syphilis is also 
treated, but not so much by the use of mercurial in- 
unctions. The French and foreign doctors at the 
French resort follow Professor Fournier, of Paris, and 
give the proto-iodide internally, and rely on the baths 
with douche-massage to eliminate the surplus or at 
least keep the skin in good order. 

Throat {Diseases of). Tonsillitis: Marlioz, Challes, 
Cauterets, Allevard, Uriage, Ems, Homburg. 



— 75 — 

Pharyngitis: St. Honore, Pierrefonds, Ems, Eaux 
Bonnes, Schinznach, Soden. 

Ulcerated throat: Aix-les-Bains, Aix-la-Chapelle, 
Baden, Uriage. The mild winter climates, Nice, 
Cannes, Mentone, etc. 

All the remarks under Bronchitis can be referred 
to for these cases. 

Tuberculosis. See Strumous Affections. — In treat- 
ing young children who are strumous, the sea baths 
of the Mediterranean have a certain advantage over 
those of the Atlantic, being more salt, without break- 
ers, and in a warm climate, so that baths can be taken 
all the year round. Cannes has a better beach than 
Nice, but there are good spots all along the coast. 

See under Phthisis and note that all the sulphur 
baths are useful in these states, while the so-called 
inland mountain salt springs are often more useful 
than the sea itself. Nauheim in Germany, Salins- 
Moutiers in France, Droitwich in England, are ex- 
amples. 

Uterus {Diseases of). — Women's diseases and all 
the pelvic affections are treated at many of the springs 
with great success: Franzensbad, Baden, St. Sauveur, 
Marlioz, Aix, Luchon, Brides, Kissingen, Kreuznach, 
Marienbad, Bath, Royat, Schwalbach, Spa, Woodhull- 
Spa, Pyrmont, Gastein, Wiesbaden, Bourbon l'Arch- 
ambault. The mild winter climates, as already said, 



- 76 - 

are indicated in all diseases of women, whose special 
functions are performed there better than in the North 
in winter. 

Varicose Veins. — Alkaline waters, Vichy, etc., are 
better than the hot sulphur-waters, but care must be 
taken in all cases not to bring on phlebitis by exces- 
sive massage and the use of baths. 

Venereal Excess. — Gastein. See Hydropathic Es- 
tablishments, page 54. 

Wounds. — Old gun-shot wounds are treated at 
the hot sulphur-springs, such as Bareges, Luchon, Aix, 
Teplitz, also at La Bourboule, while the mud baths of 
Dax, and Marienbad are given with success. 






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SOLUBLE ELASTIC CAPSULES OVERCOME 
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and simple method of keeping his accounts on a business basis. 

PALATABLE PRESCRIBING (Third Edition) 1 .00 

By B. W. Palmer, A.M., M.D. 

This book contains over 600 favorite formulas of the most eminent medical 
authorities, culled from their published writings and private records, and 
embraces a resume of the most eligible preparations for the administration 
of the more recent additions to the materia medica. 

A NEW TREATMENT OF CHRONIC METRITIS. . 50 

By Dr. Georges Apostoli. 

This book of iiq pages, illustrated with cuts of apparatus, presents the details 
of Apostolus treatment by intra-uterine Chemical Galvano-Cauterizations 
of Chronic Metritis and Endometritis. 

SANITARY SUGGESTIONS (Paper) .25 

By B. W. Palmer, M.D. 

FORMULAE FOR THROAT AND LUNG DISEASES 25 

By E. L. Shurly, M.D. 

These are formulae which Dr. Shurly employs in hospital and private practice, 
and which he has published at the solicitation of his students . 

UNUSUAL BARGAIN! 

The following three boohs will be sold, for a limited time, at half their 
regular price. Prices quoted are strictly net cash with order. 

UNTOWARD EFFECTS OF DRUGS $ 1 .00 

By L. Lewin, M.D. 

MICROSCOPICAL DIAGNOSIS 1 . 50 

By Chas. H. Stowell, M.S. 

SELECT EXTRA-TROPICAL PLANTS 1 . 50 

By Baron Ferd. von Mueller. 

GEO. S. DATZTS, Publisher, 

P. O. Box 470, 

DETROIT, - - MICH. 



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